Document Detail


Life-threatening primary postpartum hemorrhage: treatment with emergency selective arterial embolization.
MedLine Citation:
PMID:  9680559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively evaluate the efficacy and safety of emergency selective arterial embolization in the management of intractable primary postpartum hemorrhage. MATERIALS AND METHODS: Twenty-seven consecutively seen women with life-threatening primary postpartum hemorrhage underwent uterine embolization. In all cases, hemostatic embolization was performed because of intractable hemorrhage that could not be controlled with vaginal packing and administration of uterotonic drugs. The mean hemoglobin level before embolization was 7.48 g/dL +/- 2.39 (74.8 g/L +/- 23.9) (1 standard deviation). Hysterectomy performed in two patients before embolization failed to stop the bleeding. RESULTS: Angiography revealed extravasation in nine patients and spasm of the branches of the internal iliac artery in five. The procedure consisted of embolization of uterine (n = 46), vaginal (n = 5), or ovarian (n = 2) arteries or anterior division of internal iliac arteries (n = 8). Immediate disappearance or dramatic diminution of external bleeding was observed in all cases. Two patients needed repeated embolization the next day. No major complication related to embolization was found. In one patient with placenta accreta, delayed hysterectomy was necessary. Normal menstruation resumed in all women except the two who underwent hysterectomy. One woman became pregnant after embolization. CONCLUSION: Emergency arterial embolization is a safe and effective means of control of primary postpartum hemorrhage. The procedure obviates high-risk surgery and allows maintenance of reproductive ability.
Authors:
J P Pelage; O Le Dref; J Mateo; P Soyer; D Jacob; M Kardache; H Dahan; D Repiquet; D Payen; J B Truc; J J Merland; R Rymer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  208     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1998-08-05     Completed Date:  1998-08-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  359-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Body and Vascular Imaging, Hôpital Lariboisière, AP-HP, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Embolization, Therapeutic*
Emergencies*
Female
Follow-Up Studies
Humans
Hysterectomy
Iliac Artery / radiography
Ovary / blood supply
Postpartum Hemorrhage / radiography,  therapy*
Pregnancy
Prospective Studies
Treatment Outcome
Uterus / blood supply*
Vagina / blood supply
Comments/Corrections
Comment In:
Radiology. 1999 Mar;210(3):876-8   [PMID:  10207497 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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